FDA Adverse Event Injury Summary report: N

ARTHROSCOPE

MDR report key: 2900242 · Received January 7, 2013

Report

Report Number
1030489-2013-00079
Event Type
Injury
Date Received
January 7, 2013
Report Date
December 9, 2012
Manufacturer
MEDTRONIC SOFAMOR DANEK USA, INC
Product Code
HRX
PMA / PMN Number
K981251
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4): NEITHER THE DEVICE NOR FILMS OF APPLICABLE IMAGING STUDIES WERE RETURNED TO THE MANUFACTURER FOR EVALUATION. THEREFORE, WE ARE UNABLE TO DETERMINE THE DEFINITIVE CAUSE OF THE REPORTED EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT A BALLOON KYPHOPLASTY PROCEDURE (BKP) FOR A VERTEBRAL FRACTURE AT L1 DUE TO TRAUMA. IT WAS REPORTED THAT THE PATIENT DEVELOPED A RE-FRACTURE OF THE POSTERIOR WALL AT L1 SOMETIME POST-OPERATIVELY. IN ADDITION, THE SPINAL CORD WAS REPORTEDLY COMPRESSED AND CAUSED PARALYSIS. A SECOND SURGERY WAS PERFORMED VIA LAMINECTOMY WITH INSTRUMENTATION OF SCREWS. NO OTHER INFORMATION WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
6481 ARTHROSCOPE HRX MEDTRONIC SOFAMOR DANEK USA, INC NA UNK

Patients

Seq Age Sex Outcome Treatment
1 00074 YR Required Intervention